lumbar radiculopathies

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QUESTION: L4-5 lumbar radiculopathy, due to disc bulge....my answer is 722.73, but my friend says 724.4 and 722.10. Please advise, anyone.

Thanx in advance:)
 

RenaHall

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Radiculopathy 2@ to disc bulge

724.4 is a possibility but 722.10 is not. A bulge is not the same as a herniation and "displacement" refers to a herniation. I would go 722.73first and then 724.4 since this is an unspecific code.
Rena
 

Mary Baierl

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Rena, a disc bulge and a disc displacement are not the same? I was under that impression. My CPT book has a statement underneath code 722.10 that includes "neuritis or radiculitis due to displacement or rupture of lumbar intervertebral disc.

I am still learning the finer points of pathoanatomy. What exactly is a disc bulge then?

Thank you so much for helping to teach me.
Mary Baierl, CPC, CCA, CMT
 
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TLVANDERPOOL

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I found the below information when I was researching hernia vs bulging disc. Also if you view the "coding clinic, fourth quarter 2002 page 107 - 108" is has that bulging disc of lumbar intervertebral disc coded with DX 722.10 when you view the ICD-9 book and look at code 722.10 it is coded as displacement this code does not specifically state it can only be used for a herniated disc just any "dispacement" of intervertebral disc and both hernia and bulge are displacements. I would have coded your example with just 722.10 - per reference under this code in ICD-9 radiculapaty is included in this code. I hope this information is helpful.

(What is the difference between a bulging and herniated disc? Disc disorders are contained or non-contained. A bulging disc is an example of a contained disc disorder. A bulging disc has not broken open; the nucleus pulposus (new-klee-us pul-poe-sis) remains contained within the anulus fibrosus (an-you-lus fye-bro-sis). A bulging disc could be compared to a volcano prior to eruption and may be a precursor to herniation. The disc may protrude into the spinal canal without breaking open. The gel-like interior (nucleus pulposus) does not leak out. The disc remains intact except a small bubble pops out attached to the disc.
A non-contained disc is one that has either partially or completely broken open; a herniated or ruptured disc. To illustrate imagine a tube (anulus fibrosus) of toothpaste (nucleus pulposus) placed under pressure. The pressure causes the toothpaste within the tube to move wherever it can. If any part of the tube is weak toothpaste may leak out. When a disc herniates the contents may spread out to the spinal cord and nerves. The disc material has little space to go --- into the area occupied by the spinal canal and nerve roots.)
 

jdemar

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722.10 Disc Bulge

I agree with the 722.10 DX. When checking under the description of 722.10 if you will note, the last descriptor as-'Any condition classifiabel to 722.2'. When checking under code 722.2 it is stated Intervertebral disc NOS: extrusion/protusion, hence bulging disc....in the ICD-9-CM. That is my interpretation.:)
 
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